ACS Advocacy Brief: March 9, 2023

Comprehensive Universal Background Check Legislation Reintroduced in Congress

The Bipartisan Background Check Act and the Background Check Expansion Act recently were reintroduced in Congress by Representatives Brian Fitzpatrick (R-PA) and Mike Thompson (D-CA) and Senator Chris Murphy (D-CT).

Since 1993, the National Instant Criminal Background Check System (NICS) has conducted background checks on potential firearms purchasers to determine eligibility. However, there is a loophole in federal law; no background check is required for sales at gun shows, through online marketplaces, or between private individuals. Individuals who would otherwise be prohibited from purchasing or possessing a firearm easily can buy them through such unregulated sales. These House and Senate bills would close this loophole and require that all firearm sales go through the NICS.

The ACS Committee on Trauma (COT) has led efforts to prevent firearm injury and death for decades. In 2018, the COT released a set of 13 recommendations from its Firearm Strategy Team (FAST) Workgroup, with proposals including strategies and tactics to reduce firearm injury, death, and disability in the US. One of these recommendations includes support for a robust and accurate background check for all firearm purchases and transfers.

Learn More about Developments in Firearm Injury Prevention

Earlier this week, the ACS and other stakeholder organizations released the proceedings from the Second ACS Medical Summit on Firearm Injury Prevention, held in September 2022 at ACS Headquarters, in the Journal of the American College of Surgeons. This freely accessible article outlines action items and next steps in reducing firearm violence, including a strong advocacy component.

Lawmakers Reintroduce REDI Act to Ease Student Loan Debt for Physicians

Representatives Brian Babin, DDS (R-TX) and Chrissy Houlahan (D-PA) recently reintroduced the Resident Education Deferred Interest (REDI) Act, which would allow borrowers in medical or dental internships or residency programs to defer student loan payments without interest until the completion of their programs.

Physicians often accumulate immense student debt during their education and then must undertake several years of residency training with low pay, during which time their student loans accrue significant interest. This financial burden may pose a barrier for students wishing to pursue certain specialties, practice in underserved areas, or even enter the healthcare profession at all. The REDI Act is designed to alleviate some of the financial burden of medical education and help address ongoing healthcare provider shortages to ensure patients can access the care they need.

The ACS has supported this legislation since its initial introduction in 2022. Read the ACS letter of support.

ACS Outlines Concerns with New Rural Emergency Health Designation

In a January ACS Brief, the College informed members about a voluntary program that took effect on January 1 designed to help rural hospitals in the US keep their doors open, even if they cannot afford a fully operational inpatient unit.

The ACS Advisory Council for Rural Surgery has reviewed the information regarding the Rural Emergency Health (REH) Program and, along with the Board of Regents, bring forward the following concerns of which all surgeons—especially those practicing in rural communities—should be aware:

• Hospitals and hospital systems may choose to participate in this program to improve the financial health of a rural facility without discussing it with the physicians and surgeons or the community. Close relationships with hospital leadership and open discussion of this potential issue will help avoid any surprises. Surgeons in rural communities should have open and candid conversations with their hospital leadership to provide a surgical perspective if there are considerations for transitioning to the REH program.
• There is concern about the impact on patients in communities where a facility is transitioned to an REH. The reduction in total beds will further pressure acute care inpatient facilities that are limited in accepting transfers. 
• The increased distance to surgical care will diminish access to vulnerable populations and delay access to surgical care for trauma, increasing mortality.
• There is concern about access to transportation resources, which are frequently limited in rural communities, to move patients from the REH to an acute care inpatient facility where they will be admitted. This is already a challenge in higher acuity patients that would not be admitted to the critical access hospital.
• This new process may impact the types of surgical cases that can be done in a hospital that elects to transition to an REH, and it may impact the diversity or depth of surgical specialists and procedures that are performed in critical access hospitals.

The ACS will continue to actively monitor this new program and its impact on patients’ access to care. With concerns for potential healthcare social disparities being worsened by the reduction of acute care inpatient services in rural communities, the ACS is working with the Centers for Medicare & Medicaid Services and Congress to refine this program. 

While some facilities may require REH status to maintain services and avoid closure, the potential negative consequences should be considered when evaluating this program as an option. We will continue to look for opportunities to influence changes in the legislation as Congress reviews the impact of the current model. 

Train in Advocacy, Immediately Put Skills to Use during Advocacy Summit

Advocating for policies that advance surgery at the local, state, and federal levels is a critical skill as healthcare and surgery face unprecedented challenges in 2023 and beyond. Learn the skills to make advocacy inroads, and then make an impact by meeting leaders from Congress. Register today for the ACS Leadership & Advocacy Summit, April 15–18 at the Grand Hyatt Washington, DC. 

The Summit offers comprehensive and specialized sessions providing ACS members, leaders, and advocates with topics focused on effective surgeon leadership, as well as interactive advocacy training with coordinated visits to Congressional offices.

Train for Advocacy and Meet Lawmakers

The Advocacy Summit will take place Sunday evening, April 16 to Tuesday, April 18, and provides US members with an update on ACS policy priorities. 

In addition to a keynote address on Sunday evening, Monday panel sessions will cover issues including physician payment; diversity, equity, and inclusion; healthcare quality; advocacy asks for the 118th Congress from healthcare groups outside the surgeon community, and more.

Advocacy training and scheduled congressional visits will be provided as part of the event. ACS staff will send ACS members to the Hill equipped to ask Congress for progress on a range of issues, including but not limited to:

• Stabilizing and Reforming Medicare physician payment
• Prior Authorization relief
• Funding for:
• Cancer research
• Firearm injury prevention research
• Rare surgery on a global scale
• ACS trauma policy priorities
• Commission on Cancer policy priorities

The Advocacy Summit will be an in-person event with some recorded sessions. There will be no virtual option to view the Advocacy Summit. Congressional meetings will also be in-person this year for the first time since 2019. 

Check Out the Leadership Summit

Preceding the Advocacy Summit, the Leadership Summit will take place Saturday evening, April 15, to Sunday, April 16, and will offer compelling speakers addressing key topics in surgical leadership. 

Both in-person and virtual attendance options are available. The Leadership Summit will be livestreamed, and the sessions also will be recorded for future viewing opportunities by both in-person and virtual registrants.   

Learn about Revamped Hernia Coding, Major Changes to Medicare Billing at In-Person ACS Coding Courses

You are invited to register for an in-person ACS/Karen Zupko & Associates (KZA) Current Procedural Terminology (CPT) coding course in 2023, March 16–17, 2023, in Orlando, FL, and August 3–4 in Nashville, TN.

With Medicare and third-party payer policy and coding changes taking effect in 2023—some with significant potential reductions in payment for surgeons—it is imperative that surgeons and their coding staff have accurate and up-to-date information to protect reimbursements while optimizing efficiency.

• March 16–17, 2023
  Wyndham Grand Orlando Resort, Bonnet Creek, FL
  Reservation Phone: 407-390-2300
  Register today!
• August 3-4, 2023
  Loews Vanderbilt Hotel, 2100 West End Avenue, Nashville, TN
  Reservation Phone: 877-879-7818
  Register today!

Both courses include sessions on Hospital E/M & Critical Care Coding, Thursday 1:00–5:00 pm, and General Surgery Coding, Friday 8:00 am–4:00 pm.

Session #1: Reporting Hospital E/M Codes and Split/Shared and Critical Care Services Course

Topics covered will include E/M codes for inpatient/facility, major changes in CPT code selection, and major changes to Medicare’s billing rules for both split/shared services and critical care.

Session #2: General Surgery: Revenue and RVU Optimization Course

Topics covered will include discussion of the revamped abdominal hernia codes, including use of the same CPT codes for both laparoscopic and open procedures and basing codes on the total size of the hernia. The revised hernia codes have been a topic of significant interest for general surgeons and administrators alike, so make sure to learn the latest from the experts.

In addition, this second session will cover coding for endoscopy, colorectal, and breast, among other procedures.

ACS members and their staff receive a registration discount. If you have any issues with completing your registration, email KZA at education@karenzupko.com or call 312-642-8310.

For more information or questions about the 2023 ACS live coding workshops, visit the KZA website or send an e-mail to practicemanagement@facs.org.